Long-term observation of the refraction with a reversed-optic posterior chamber intraocular lens

A 73-year-old man had phacoemulsification and implantation of a posterior chamber intraocular lens (PC IOL) in both eyes. In the right eye, the optic was unintentionally reversed in the bag. In the left eye, the posterior capsule was ruptured and the IOL haptics were fixated in the ciliary sulcus. The refraction in the sulcus-fixated left eye was stable from 1 month to 4 years. The right eye had a myopic shift at 1 month, with a regression of 1.50 diopters that continued for 2 years. The final IOL position in the right eye was 0.25 mm anterior to the position predicted by the SRK/T formula. It took 2 years for the refraction in the eye with the reversed-optic PC IOL to become stable. A large myopic shift and gradual regression in refraction may stem from a different wound-healing reaction than that of properly fixated IOLs.